Background/Purpose:
Self-management support (SMS) –a grouping of policies, programs, services, and structures that extend across health care, social sectors and communities to support and improve the way individuals manage their chronic conditions—is important in both health care delivery and population-based public health approaches, in the United States and internationally. However, SMS initiatives have evolved differently in different professional disciplines, service systems and countries, with very limited cross-fertilization among them. The purpose of this project was to establish a framework of SMS (definitions, guiding principles, and strategic directions) to guide the development of self-management support initiatives locally, regionally, nationally and internationally. The purpose of this paper is to report on the international framework that emerged from an international electronic consultation process.
Methods:
The British Columbia Center of Excellence for Women’s Health hosted a three day roundtable discussion among twenty-three opinion-leaders from five English-speaking countries to explore SMS from a broad system perspective encompassing health care delivery, public health, and the social services sectors; a wide variety of funding sources supported the initiative. Roundtable participants were selected to represent a balance of policy, practice, and research perspectives across the US, Canada, Australia, the UK, and New Zealand. A preliminary draft framework was developed using a thematic analysis of the roundtable proceeding; the draft framework was refined through two rounds of a modified Delphi process among roundtable participants.
International electronic consultation was conducted using an online survey tool. A snowball sampling technique was used to gather international responses to the key elements of the draft framework. Data was collected using an on-line survey tool.
Results:
A total of 204 reviewers from 16 countries responded to the electronic consultation. Representation by country ranged from 31% (Canada) to 1% (9 countries including Austria, Brazil, Denmark, Germany). 24% of respondents were researchers, 18% health care providers, 7% policy-makers, 6% consumers or patient advocates.
96% of respondents agreed or strongly agreed with the definitions of self management and self management support. The final draft framework contained eight guiding principles and seven strategic directions, with international agreement ranging from 94-96% and 98-99% respectively.
Conclusion:
The international electronic consultation demonstrated strong international agreement with the definitions, guiding principles, and strategic directions that emerged from the modified Delphi process. While the original draft framework was developed by opinion-leaders in 5 English-speaking countries, the framework also resonated with respondents from 11 other countries where English is not the national language. While SMS developments need to reflect local, regional, and national needs, this international framework provides an emerging consensus on strategies to move the field forward across multiple perspectives and countries.
Disclosure:
T. J. Brady,
None;
S. Mills,
None;
P. Sargious,
None;
S. Ziabakhsh,
None.
ACR Meeting Abstracts - https://acrabstracts.org/abstract/an-international-framework-for-chronic-condition-self-management-support-results-from-an-international-electronic-consultation-process/